NHS reaches a tipping point

The British Medical Association (BMA) doctors' organisation has called for the government's destructive Health and Social Care Bill to be withdrawn or 'significantly amended'. The BMA's head, Hamish Meldrum, says the bill would change the National Health Service (NHS) into "a market-based health system rather like the one we see in the United States".

In particular he criticised the government for forcing all hospitals to become semi-autonomous Foundation Trusts (initiated by the previous Labour government) which, under the pressure of massive government spending cuts, will increase the numbers of paying private patients at the expense of poorer patients.

At present many health trusts are saddled with enormous 'debts' due to a combination of government 'efficiency savings' (ie cuts) and private finance initiative (PFI) schemes.

Managers at Imperial College Healthcare NHS Trust for example are considering shutting St Mary's Hospital in Paddington, west London, with the loss of 500 beds, and selling off the site to property developers in order to eliminate its £100 million 'debt'.

Privatisation

PFI schemes typically are 20-35 year contracts whereby health trusts get private consortiums to build and refurbish hospitals and provide maintenance and other services for an enormous fee.

In August 2010 the department of health said NHS organisations will, through PFI schemes, eventually pay over £50 billion for buildings worth £11 billion, with maintenance charges adding a further £15 billion in costs.

The health bill will accelerate privatisation of the NHS. Already Hinchingbrooke NHS Hospital in Cambridgeshire has been effectively privatised and leaked emails between senior health officials show that government ministers are considering privatising 10-20 hospitals to for-profit international private health care companies. Clearly any inherited debt, if not borne by the public purse, will result in job cuts, ward and department closures.

The health bill will also end the health secretary's legal obligation to deliver comprehensive health care to patients. If the local health trust cannot afford to provide health care than patients will either have to go private or simply go without.

Clearly the NHS is at a tipping point. Unless health workers' trade union organisations, along with local communities, launch a major counter-offensive to demand a fully funded, publicly owned and democratically run NHS, then a two-tier health service will emerge with the vast majority of people suffering.